“ADHD? No, you are just lazy…” Thousands of misconceptions surround the most common neurodevelopmental disorder, with the majority of children taking attention-deficit/hyperactivity disorder (ADHD) medication and nearly half undergoing behavioral treatment for this specific disorder (CDC, 2022). Despite these widespread statistics, ADHD continues to remain misunderstood by parents and frequently goes undiagnosed. The symptoms of ADHD directly influence children's cognitive systems, leading affected individuals to experience high levels of repetitive actions and hyperactivity, coupled with challenges in managing these symptoms. They also have a short attention span, affecting daily tasks such as conversing or remembering small responsibilities.
Remarkably, these symptoms persist into adulthood, significantly impacting various aspects of life, including academic and professional performance (Faraone et al., 2021). Some cognitive features severely shaped by ADHD include executive functions, memory, and attention, causing individuals with ADHD to perform significantly worse in school compared to those without ADHD (Mautone et al., 2011). Due to their cognitive dysfunctions, undiagnosed individuals with ADHD are often misunderstood to be academically incompetent throughout adolescence. However, the central question is whether this dysfunction is genuinely linked to competence, or if ADHD merely influences learning patterns.
Neuroimaging studies reveal differences in brain function and structures among individuals with ADHD, with the most notable variation observed in gray matter concentration. Diagnosed participants’ brains are scanned and visualized using a Magnetic Resonance Imaging (MRI) scanner, enabling precise imaging of human anatomy. The collected images reveal that ADHD brains exhibit atypical cognitive and behavioral functions prominently (Gehricke et al., 2017). In a typical human brain, a stronger working memory—crucial for temporarily encoding information—is associated with higher gray matter volume in specific regions, including the frontal lobe, cerebellum, and temporal lobe. The primary distinction in the ADHD brain lies within the frontal lobe, responsible for executive functions like attention, impulse control, and decision-making (Burztbach et al., 2019). Specifically, these findings demonstrate a decreased gray matter concentration, contributing to working memory impairments in individuals affected by ADHD (Duan et al., 2018).
ADHD diagnosis during different developmental periods is correlated with dissimilar changes in brain wiring. The white matter concentration matures conversely among children, adolescents, and adults with ADHD. In our brains, white matter tracts are associated with visuospatial attention, cognitive control, and emotional regulation (Versace et al.,2021). A study in children and adolescents with ADHD demonstrates white matter abnormalities in the brain, displaying a reduction in white matter for adolescents and children with ADHD. However, adults affected by ADHD have increased white matter, indicating different neural patterns across ages (Bouzine et al., 2017). Another study suggested improvement in symptoms as affected individuals transition from adolescence to adulthood, a trend that may be correlated with increased white matter observed in adults with ADHD (Shaw et al., 2015). Nonetheless, these studies do not provide a comprehensive understanding of white matter dysfunctions in the ADHD brain, leaving room for future research. However, opposite maturing patterns of white matter among ages confirm that those neural differences potentially explain why individuals with ADHD may not be as “competent” at school and/or in the workplace compared to their peers.
While understanding the variations in ADHD brains does not identify the exact causes of the disorder, it does propel us toward the eventual discovery of the origins of ADHD. These insights could provide useful diagnostic accuracy, as well as distinguishing ADHD from other conditions with similar symptoms. Nevertheless, these should help eliminate stigmas and misconceptions about undiagnosed individuals and encourage them to seek professional help. Recognizing and embracing these differences is as crucial as striving to alleviate the challenging symptoms. It's important for people to grasp the neurological factors contributing to diverse learning patterns, rather than wrongly perceiving individuals with ADHD as lacking competence. Consequently, individuals with ADHD should be provided with adequate support, such as granting them more learning accommodations, to enable their success in both academic settings and professional areas.
References
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